Yıldırım Aydın Feray, Dülger Dilek
Department of General Surgery, 29 Mayıs State Hospital, Ankara-Turkey.
Department of Microbiology, Karabük University Faculty of Medicine, Karabük-Turkey.
Ulus Travma Acil Cerrahi Derg. 2020 Mar;26(2):242-246. doi: 10.14744/tjtes.2020.06623.
The degree of damage presents a pressing issue in determining trauma severity. Various trauma-scoring systems, such as the injury severity and revised trauma scores, are used worldwide. In this study, we aimed to evaluate the functionalities of these two trauma scoring systems, which are presently used frequently and have scientifically evolved at the state hospital level.
Following approval from the ethics committee to conduct clinical studies with retrospective archive screening, data between January 1, 2012, and December 31, 2017, were retrospectively analysed for determining the factors affecting mortality in all patients diagnosed with traumatic injury in 29 Mayıs State Hospital. Incomplete or unclear data were excluded from this study. Mean and standard deviation were used for continuous variables; percentage and frequency values were used for binary variables. For evaluating continuous variables, Student's t-test or Mann-Whitney U-test was used in independent groups based on their distribution status. Dichotomous variables were evaluated using the chi-square test. The results and significant in univariate analyses were evaluated again by the linear and binary logistic regression model.
Mean age of all patients was 37.53±14.47 years [male (35.68±13.9) versus female (40.61±15.1) (p=0.116)]. Mean injury trauma score for the general population was 3.18±8.46. No dissimilarity was noted regarding gender for the injury severity score (ISS) [(3.93±10.49 versus 1.91±2.34) (p=0.727)]. Regarding age, for revised trauma score (RTS), no statistical significance was noted [(7.60±0.91 versus 7.81±0.16) (p=0.207)]. Regarding the injury mechanism, we detected a difference between the two trauma scores; both ISS and RTS also had statistical significance. The results were found for ISS [penetrant (6.56±6.47) versus blunt (2.45±8.68) (p=0.002)] and for RTS [penetrant (7.41±0.54) versus blunt (7.74±0.79) (p=0.001)]. After the final statistics with logistic linear regression, the respiratory rate was statistically significant for penetrant injury [AOR 0.22 (0.001, 0.47) (p≤0.05)]. In the detailed subanalysis for RTS score components, respiratory rate was also significant in moderate traumas [AOR 0.22 (0.001, 0.47) (p=0.004)].
Both ISS and RTS are nonsignificant in all moderate injury types. On the other hand, respiratory rate is an important marker, especially in penetrant moderate injuries.
损伤程度是确定创伤严重程度时的一个紧迫问题。世界各地都在使用各种创伤评分系统，如损伤严重度评分和修订创伤评分。在本研究中，我们旨在评估这两种目前经常使用且在州立医院层面有科学发展的创伤评分系统的功能。
在伦理委员会批准进行回顾性档案筛查的临床研究后，对2012年1月1日至2017年12月31日期间的数据进行回顾性分析（数据来自于5月29日州立医院所有诊断为创伤性损伤的患者），以确定影响死亡率的因素。本研究排除了不完整或不清楚的数据。连续变量使用均值和标准差；二元变量使用百分比和频率值。为评估连续变量，根据其分布状态在独立组中使用学生t检验或曼-惠特尼U检验。二分变量使用卡方检验进行评估。单因素分析中的结果及显著性通过线性和二元逻辑回归模型再次进行评估。
所有患者的平均年龄为37.53±14.47岁[男性（35.68±13.9）与女性（40.61±15.1）（p = 0.116）]。总体人群的平均损伤创伤评分为3.18±8.46。损伤严重度评分（ISS）在性别方面未发现差异[（3.93±10.49与1.91±2.34）（p = 0.727）]。关于年龄，对于修订创伤评分（RTS），未发现统计学意义[（7.60±0.91与7.81±0.16）（p = 0.207）]。关于损伤机制，我们在两种创伤评分之间检测到差异；ISS和RTS也具有统计学意义。ISS的结果为[穿透伤（6.56±6.47）与钝器伤（2.45±8.68）（p = 0.002）]，RTS的结果为[穿透伤（7.41±0.54）与钝器伤（7.74±0.79）（p = 0.001）]。经过逻辑线性回归的最终统计，呼吸频率在穿透伤中具有统计学意义[AOR 0.22（0.001，0.47）（p≤0.05）]。在RTS评分成分的详细亚分析中，呼吸频率在中度创伤中也具有显著性[AOR 0.22（0.001，0.47）（p = 0.004）]。
ISS和RTS在所有中度损伤类型中均无显著性。另一方面，呼吸频率是一个重要指标，尤其是在穿透性中度损伤中。
